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发表于 2013-8-26 13:34:26
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紫色尿袋综合症（PUBS）：是尿管留置一段时间后，尿管及尿袋色素沉着，颜色从淡紫色或蓝色变成深蓝色或深紫色。
原理：是饮食中色氨酸代谢产物吲哚硫酸盐降解所致，患有慢性便秘及胃肠道消化功能障碍的患者，因肠蠕动及消化功能查差，食物在肠道内停留时间长，食物F·B产生吲哚物质，在大肠快速被吸收，经由肝门循环之肝脏转变成氧靛基质硫酸盐，经尿液排除后转变成氧靛基质。上述过程经大肠杆菌及碱性尿液的条件下，氧靛基质转变成蓝色靛蓝和红色的靛玉红，这些颜色混合后呈现紫色。
预防措施：
1.必须经常注意患者留置导尿颜色
2.患者需摄取大量维生素C维持酸性尿液，改善肠道环境如加强腹部按摩及多摄取水分
3.经常更换尿管尿袋，保持皮肤及生殖器官的清洁
4.加强卫生健康教育
附：Purple urine bag syndrome may not be benign: a case report and brief review of the literature
Bhattarai M, Bin Mukhtar H, Davis TW, Silodia A, Nepal H.
Department of Internal Medicine, Geisinger Medical Center, 100 North Academy Avenue, Danville, PA 17822, USA.2013;2013:863853. doi: 10.1155/2013/863853. Epub 2013 Jun 20.
Purple urine bag syndrome (PUBS) is a rare condition in which there is purple discoloration of the urine with its collecting bag and associated tubing occurs. It is considered a benign condition. We report an unusual case of PUBS in an 87-year-old female from nursing home who had a history of recurrent UTI. She also had a history of ureteral obstruction requiring left nephrostomy tube. She was brought to emergency department with altered mental status which developed five days after the occurrence of purple discoloration of the urinary bag. Her urine culture grew vancomycin-resistant Enterococci (VRE) and Pseudomonas aeruginosa. She died within three days of hospitalization despite intensive care in tertiary center. This case highlights that PUBS may not always be benign and should be approached on a case-by-case basis because it may signal the underlying UTI which might be very difficult to treat. Failure of recognition of this peculiar color early could delay the appropriate intervention leading to fatal complication. This case also represents the rare occurrence of PUBS in the setting of nephrostomy tube.
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